Surgery, 'Sham' Equal in Treating Compression Fracture Pain

Injecting cement into spine no better than placebo procedure, study finds

By Amanda Gardner
HealthDay Reporter

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WEDNESDAY, Aug. 5 (HealthDay News) -- Two new studies suggest that vertebroplasty, a widely used surgery to help heal compression fractures, is no better than "sham" surgery when it comes to relieving pain and improving daily function.

But both procedures resulted in a significant decline in pain, so this is unlikely to signal the death knell for this widely performed surgery, experts noted.

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"From a clinician's standpoint, it's important to read this data and be aware of it," said Dr. L. Gerard Toussaint III, an assistant professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine and a neurosurgeon at Texas Brain and Spine Institute in Bryan.

Vertebroplasty involves injecting a type of "cement" into the spine to stabilize it, thereby relieving pain and reducing disability in people who have had osteoporotic fractures.

The procedure is minimally invasive and often performed under local anesthetic, with the patient going home the same day, Toussaint said.

In the United States alone, some 750,000 people have vertebral compression fractures each year. According to an editorial that accompanies the studies, all appearing in the Aug. 6 issue of the New England Journal of Medicine, the number of vertebroplasty procedures performed in the United States has doubled in the past six years, from 4.3 to 8.9 per 1,000 people.

Several studies have found great benefit from the procedure, but none of those were placebo-controlled.

Experts also worry that there may be a downside, with the surgery putting patients at higher risk for future fractures.

One trial, from Mayo Clinic researchers, randomly assigned 131 patients who had had one-to-three osteoporotic vertebral compression fractures to receive either vertebroplasty or a "sham" surgery without cement.

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